Science: It’s a Girl Thing 2016
Calling all future scientists. . .
SIGT is a 5 day, 4 night residential camp for girls entering 5th
through 12th grades. Participants will reside in university
residence halls on the Texas Tech campus. During the day,
girls attend exciting hands-on science classes in university
classrooms and laboratories. Evenings are devoted to
traditional summer fun.
PROGRAM GOALS
■ Provide girls with strong role models
■ Spark interest in science
■ Dispel myths and misconceptions
about science and careers in science
■ Introduce under-represented girls to
a collegiate experience
IMPORTANT DEADLINES
Application deadline:
May 1, 2016
Refund deadline:
May 22, 2016
Camp Tuition: $500
REFUND POLICY
A refund request should be made in
writing and include the address of
the refund recipient. No fees will
be refunded after May 22, 2015.
The refund-processing fee is $25.
HOUSING
Students are housed in a residence hall
at Texas Tech University. Each camper
will have one roommate. Campers may
request a roommate (not guaranteed).
Meals are served daily in a Texas Tech
dining hall.
CLASSES
All classes are taught by experienced
university or public school faculty
and emphasize hands-on activities.
Classes are interdisciplinary and allow
campers to explore many aspects of
science through the lens of a scientific
discipline. Campers are assigned to two
different classes before camp starts
based on their autobiographical
statement
REGISTRATION GUIDELINES
Tuition includes instruction,
supervision, room and board, linen
package, a camp t-shirt, and evening
recreation. All applicants must
complete parts A and B of the
registration form.
Session I: June 5-9, 2016
Girls Entering Grades 5th & 6th
Session II: June 12-16, 2016
Girls Entering Grades 7th & 8th
Girls Entering Grades 9th –12th
IDEAL – Institute for the Development and Enrichment of Advanced Learners
Have a question?
IDEAL: (phone) 806.742.2420 • (fax) 806.742.2396
ideal@ttu.edu
www.ideal.ttu.edu
www.facebook.com/TexasTechIdeal
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
Instructions: Complete sections A and B. Each applicant, including past participants,
must submit a one-page autobiographical statement stating your reasons for wanting
to attend Science: It’s A Girl Thing and include the areas of science you are interested
in. You will be assigned to two classes based on your statement. Please see list of
potential classes being offered.
❏ To save resources, may we send program paperwork via email?
Email address
PART A
■ Please print clearly.
Student’s Name
(First) _
Birth Date:
(Last) _
/
/
Grade in Fall 2016:
Mailing Address
Family email
City
Name of Parent or Guardian (Mother)
Home Phone (
)
Work Phone (
)
Name of Parent or Guardian ( Father)
Home Phone (
)
Work Phone (
)
School Currently Attending
City
State
Zip
Cell Phone (
)
Cell Phone (
)
State
Do you have a roommate request? (Not guaranteed — both students must request
to room together)
Have you participated in any of our programs before? ❏ Yes
❏ No
If yes, which program (s)?
Where did you hear about our program?
Potential Classes to be offered
A Toxic World
Animal Science & Food Technology
Atmospheric Science
Building Blocks of Life
Chemical Engineering
Computer Science
Control Engineering
Earth Science
Electrical Engineering
Environmental Engineering
3D Design Engineering
Forensics Geology
GIS Mapping
In The Lab
LEGO Robotics
Lightning Revolution
Math
Microbiology
Physics
Physiology
Seeking Black Gold
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
T-SHIRT SIZE CHART:
T-shirt size: ❏ Youth Small (6-8) ❏ Youth Med (10-12)
❏ Youth Large (14-16)
Adult Sizes: ❏ Small ❏ Medium ❏ Large ❏ XLarge ❏ XXLarge ❏ Other
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
CAMPLIFE NECESSITIES:
What to Bring:
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Clothing for an entire week
Clothing suitable for all
weather conditions
Clothes hangers
Comfortable walking shoes
Undergarments for an entire
week
Sweater or light jacket
Camera
Class supplies (pen, pencils,
notebook)
Pillow and Blanket
Bathroom towels &
washcloths
Snacks
Hair products (i.e. shampoo,
conditioner, hairspray)
Toiletries (i.e. makeup,
sunscreen, deodorant, body
wash)
Toothbrush/toothpaste
Alarm clock
Money for incidentals
Appropriate swim wear
(cotton not allowed in TTU
leisure pool)
Sheets, pillow covers,
comforter
What NOT to Bring:
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Alcohol and alcohol
paraphernalia
Halogen Lamps
Toasters/toaster ovens/hot
plates/open coiled appliances
Pets
Weapons
Pellet guns
Candles/incense
George Foreman Grills
Air conditioners of any kind
Extension cords
Combustibles
Large speakers, multiple
speakers, amplifiers
Wireless router - for more
information, please visit the
IT website (www.it.ttu.edu)
Television
Video Games
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
■ PART B
Teacher Nomination (To be completed by nominating person)
In the space provided, please nominate a girl to SIGT.
Name of student
(First)
(Last)
Name of teacher or school official nominating
Nominator’s Phone
Nominator’s email
Name of School
City
State
School is a Title I school? (circle) Yes No
Very Much
Often
Sometimes
Rarely
Never
This student was eager to learn.
This student cared about other
students.
This student was late to class.
This student skipped classes.
This student turned in homework and
projects on time.
This student participated in class,
group and hands-on activities.
This student worked independently
and as a team member.
This student was an asset to the class.
This student participated in extracurricular activities (UIL, science fair,
student council, etc.).
Circle the best answer to the following question: Would you like to teach this student in
another class?
Yes, definitely
Maybe
Definitely not
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
Completion of the following, with a photocopy of proof of health insurance must
be submitted with the application. If this poses a hardship, call 806 -742- 2420.
Student’s Name:
Name of Family Physician:
Physician’s Phone Number:
Directions: Check any medical conditions that apply and provide detailed
information on all medical concerns.
All information will remain confidential. If necessary, attach a separate sheet of
paper to explain your child’s medical condition or email additional information to:
ideal@ttu.edu
❏ condition requiring medication
❏ allergies to food or medications
❏ current infections, viruses
❏ emotional or behavioral problems
❏ recent injuries, illness, operation
❏ impairment of sight, hearing, speech
❏ other
Consent to Medical Treatment
I,
Parent, Managing Conservator, or Guardian of
(Participant) hereby consent to any
and all emergency medical treatment needed by said Minor Child as administered
by a clinic or attending physician and accept responsibility for full payment of said
treatment. I give my permission for this document to be photocopied for medical
personnel.
Signature of Parent, Managing Conservator, or Guardian
Date
My child is enrolled in the Texas Tech University Science: It’s a Girl Thing Camp
❏ Session I (June 5th-9th)
❏ Session II (June 12th-16th)
(check the appropriate session)
This form is valid only for the 2016 session indicated above.
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
SIGT AIR TRAVEL FORM
Airport Transportation Fee: $25
IDEAL Staff will pick up campers from the baggage claim area and accompany
campers to and from campus. If camper is considered an unaccompanied
minor; staff will meet them at the gate. IDEAL Staff will call parent/guardian
once the student is picked up and once all have arrived at the residence hall.
IDEAL Staff will call parent/guardian once flight departs.
■ AIRPORT ARRIVAL
Arrival should be between 1:00-3:45 p.m. on Sunday of the session.
Arrival Time
Flight Number
Airline
■ AIRPORT DEPARTURE
Departure should be between 5:00 p.m. and 7:00 p.m. on Thursday of the session.
Departure Time
Flight Number
Airline
Parent Contact
C e l l Phone
Student Cell (if applicable)
Would you be interested in receiving information on upcoming dates and events?
❏ Yes
❏ No
PAYMENT
❏ $500 — Full Tuition
❏ $25 — Airport Transportation Fee (for those students travelling by air)
Make your check or money order payable to Texas Tech University.
Payment can be mailed or brought to Doak Hall, Suite 110
RETURN TO:
IDEAL
Texas Tech University
P.O. Box 41008
Lubbock, TX 79409-1008
FAX to (806) 742-2396 or email to ideal@ttu.edu
SIGT APPLICATION FORM
❏ SESSION I: Grades 5-6 ❏ SESSION II: Grades 7-12 (Check one)
I,
Parent/Managing Conservator/Guardian,
(circle one) understand that the minor child,
has the opportunity to participate in Science: It’s A Girl Thing, a program for students
sponsored by Texas Tech University, Institute for the Development and Enrichment of
Advanced Learners, Lubbock, Texas, from June 5-9 or June 12-16, 2016. I hereby affirm
that I desire to have my minor child participate in said program. I give my permission for
my minor child to ride in public transportation or in vehicles driven by Texas Tech
employees or representatives to and from designated activities. I, the undersigned, am
aware of the dangers associated with travel by motor vehicle or other conveyance and the
possibility of injuries or death while in transit. I understand that my minor child will
participate in general classroom, educational, and camp activities during this program. I
am aware of the dangers associated with such activities and the possibility of injuries or
even death in such participation. In consideration of allowing my minor child to attend
the above mentioned activities, I, the undersigned, do hereby release, indemnify, and
hold harmless Texas Tech University, its Board of Regents, all the University’s officers,
agents, and employees, and the Institute for the Development and Enrichment of
Advanced Learners from any and all liability due to injuries, damage or death arising or
resulting from any act or omission, express negligence or otherwise, of said Texas Tech
University officers, advisors, agents, and employees and other officers or members of
the Institute for the Development and Enrichment of Advanced Learners, or any other
person or participant in said activities while attending the activities or while in transit
to and from activities.
The terms hereof shall also serve as a release and an assumption of risk for my minor
child’s heirs, executor and administrator, and for all members of my child’s family and be
pleaded as a bar to litigation.
Jurisdiction of this matter and venue shall lie in Lubbock, Lubbock County, Texas.
I, the undersigned, on behalf of my minor child agree to indemnify and hold Texas Tech
University, its Board of Regents, and all the University’s officers, agents and employees
harmless from and against any and all personal injury. I am above the age of eighteen (18)
years and read this Release and Hold Harmless Agreement and voluntarily understand and
accept its terms.
Signature of Parent, Managing Conservator, or Guardian
Date:
Print or type name of Parent, Managing Conservator, or Guardian
MEDIA COVERAGE/PARTICIPATION
I hereby give permission for the name of the minor listed above to be released to the
media or for him/her to participate in any media coverage which might transpire during
the course of the program. I authorize the use of the minor’s name, biography, likeness,
voice and performance in the production of the program(s) and for the purpose of
publicizing and promoting the program(s) and/ or future related programs.
I represent that I am a parent (guardian) of the minor whose name is listed above and I
hereby agree to have my child participate in media coverage.
❏ MY CHILD MAY PARTICIPATE IN MEDIA COVERAGE
Signature of Parent, Managing Conservator, or Guardian
Date:
❏ MY CHILD MAY NOT PARTICIPATE IN MEDIA COVERAGE, and I do not wish
his/her name released to the news media.
Signature of Parent, Managing Conservator, or Guardian
Date:
A complete registration for Science: It’s a Girl Thing
includes:
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Autobiographical Statement
Part A
Part B - Teacher Nomination
Medical History & Consent to Treat Form
Release & Hold Harmless Form
Media Coverage Participation Form
Photocopy of Health Insurance (if applicable)
❏ SIGT Travel Form (if applicable)
❏ Email address (if applicable)
If you want to stay up to date with everything IDEAL CAMPS follow us on
Twitter and Instagram! Make sure you like us on Facebook too!
Twitter: @TTUIDEAL
Instagram: @TTUIDEAL
Facebook: TEXAS TECH IDEAL
From here, it’s possible.
RETURN TO:
IDEAL
Texas Tech University
P.O. Box 41008
Lubbock, TX 79409-1008
FAX to (806) 742-2396, or email to ideal@ttu.edu